急性发作或自发性气胸的住院治疗对COPD或哮喘患者生命质量、心理功能、以及抑郁和焦虑症状的影响
2013/12/30
摘要
背景：支气管哮喘或慢性阻塞性肺部疾病(COPD)患者除抑郁症状外通常还伴有较低的生命质量(QoL)。本研究的目的在于比较急性发作或自发性气胸(SP)的哮喘或COPD患者与疾病稳定患者的Qol、抑郁症状、心理功能和焦虑情况。
材料和方法：本研究纳入的是确诊为重度(三级)支气管哮喘或COPD的患者。对哮喘或COPD急性发作或SP患者进行为期超过3年的前瞻性观察。使用圣乔治呼吸问卷(SGRQ)评估QoL。另外，AQ20问卷(AQ20)、医院焦虑和抑郁量表(HADS)，以及简易精神状态检查(MMSE)也被用于本研究。
结果：本研究共纳入233例患者(112例哮喘患者和121例COPD患者；平均年龄为57.9 ± 11.9岁)。通过SGRQ的估算，COPD或哮喘患者生活质量低(哮喘和COPD平均值±标准差分别为27.5 ± 12.9和25.1 ± 10.2)。在超过3年的观察期内，需要住院治疗的哮喘急性发作(41.5 ± 11.7)、COPD急性加重(57.9 ± 14.3)或SP(65.3 ± 11.4)与较低的SGRQ分数相关。与基线比较，哮喘急性发作后平均MMSE分数显著减少(29.9 ± 2.1 vs. 27.2 ± 3.1；P < 0.05)。COPD急性加重(28.5 ± 0.9 vs. 26.9 ± 1.2; P < 0.05)以及COPD伴SP事件(28.8 ± 1.2 vs. 24.1 ± 2.2; P< 0.05)后平均MMSE分数减少。
结论：本研究显示哮喘和COPD患者的生命质量低，并存在精神损伤。此外，在因急性加重或SP导致住院治疗后，Qol显著降低。
（林江涛 审校）
J Asthma. 2013 Nov 4. [Epub ahead of print]
The influence of hospitalizations due to exacerbations or spontaneous pneumothoraxes on the quality of life, mental function, and symptoms of depression and anxiety in patients with COPD or asthma.
Filipowski M, Bozek A, Kozlowska R, Czyżewski D, Jarzab J.
Abstract
BACKGROUND: Patients with bronchial asthma or chronic obstructive pulmonary disease (COPD) frequently have a low quality of life (QoL) in addition to depression symptoms. The aim of this study was to compare the QoL, depression symptoms, mental function and anxiety in patients with asthma or COPD exacerbations or spontaneous pneumothoraxes (SP) to patients with stable disease.
MATERIALS AND METHODS: Patients with a confirmed diagnosis of severe (III degree) bronchial asthma or COPD were included in this study. Prospective observations of asthma or COPD exacerbations or SP were performed over a three-year period. QoL was assessed using St. George's Respiratory Questionnaire (SGRQ). In addition, the AQ20 questionnaire (AQ20), the Hospital Anxiety and Depression Scale (HADS) and the Mini-Mental State Examination (MMSE) were administered.
RESULTS: A total of 233 patients (112 with asthma and 121 with COPD; mean age 57.9 ± 11.9 years) were included in the study. Patients with COPD or asthma had a low QoL as estimated by the SGRQ (mean ± SD: 27.5 ± 12.9 and 25.1 ± 10.2 for asthma and COPD, respectively). Asthma exacerbations, COPD exacerbations or SP requiring hospitalization were associated with lower SGRQ scores over the three-year observation period (41.5 ± 11.7, 57.9 ± 14.3 and 65.3 ± 11.4, respectively). The mean MMSE score significantly decreased after an asthma exacerbation compared to the baseline (29.9 ± 2.1 versus 27.2 ± 3.1; p < 0.05). The mean MMSE score decreased after COPD exacerbations (28.5 ± 0.9 versus 26.9 ± 1.2; p < 0.05) and after COPD with an SP event (28.8 ± 1.2 versus 24.1 ± 2.2; p < 0.05).
CONCLUSION: Low QoL and mental impairment were observed in patients with asthma and COPD. In addition, the QoL significantly decreased following hospitalizations due to exacerbations or SP.
J Asthma. 2013 Nov 4. [Epub ahead of print]
